- Norwood (NW) classification divides hair loss in men into different types which are assigned to 7 hair loss types (1 thorough 7).
- Types, patterns, stages, classification of hair loss are all the synonyms.
- Although it clearly visualizes the most common, typical types of hair loss, Norwood classification is an anatomical one per se. It fails to take individual patterns of hair loss and certain mixed and incomplete forms of hair loss into consideration. Sometimes, it also fails to integrate some hair losses and important variables of modern hair restoration surgery.
Dr. Maral’s Grading System of Hair Loss in Men:
Grading system is based on NW classification but also takes the following variables into consideration:
- Age of the patient.
- Size (dimensions) of the head and the hair loss area.
- Presence of a complete baldness or partial thinning over the hair loss area.
- Donor area’s capacity to provide the maximum number of grafts during the first session of the FUE hair transplant.
- Donor area’s size and hair thickness over there.
- The quality of the donor grafts (average hair number per graft) and donor hair (hair caliber, hair color – healthy or atrofied hair).
- Accordingly; NW classification can be done before the operation by examination or by online consultation using pictures. Grading system is done after the FUE hair transplant.
Mild hair loss: Grade 1, Grade 2.
- The first sign of the initiation of male pattern hair loss is when a frontal recession begins to appear in the hairline.
Moderate hair loss: Grade 3, Grade 3vertex, Grade 4.
- Over time hairline recession becomes larger and more noticeable and the hairline moves further back. Independently or at the same time frontal recession is occurring, a thinning area may appear on the crown which will gradually increase in size.
Advanced hair loss: Grade 5, Grade 6.
- The bridge between front and vertex becomes very thin or totally lost with additional narrowing of the back and side portions of the donor fringe.
Severe hair loss: Grade 7, Grade 8.
- The final stage is when the hair is lost completely from the back to the frontal region, and leaving the familiar horse-shoe shape donor fringe. Grade 8 refers to thinned or atrofied donors with an advanced age; it may appear as NW 7 preoperatively.